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Evaluation of a new B. Braun flexible springwound catheter for labor epidural analgesia
Abstract Number: F 38
Abstract Type: Original Research
Introduction: Efforts to improve the efficacy of labor epidural analgesia have led to the design of different types of epidural catheters. Flexible versus rigid catheters (1), and multiport versus uniport catheters (2), have been associated with better analgesic outcomes. However, flexible catheters have been associated with breakage during removal (3), and better analgesic outcomes with multiport catheters were demonstrated using rigid and not flexible catheters. At our institution we have been using a relatively new flexible catheter (B. Braun Perifix FX springwound catheter) for labor epidural analgesia, and with 22,000 catheter placements to date we have anecdotally not experienced catheter breakage. We hereby report select data from a preliminary analysis of an ongoing prospective, controlled, randomized, blinded study of the efficacy of the multiport versus uniport B. Braun Perifix FX springwound catheter for labor epidural analgesia.
Methods: Fifty nine healthy ASA I-II parturients of mixed parity, with a singleton term cephalic gestation, in spontaneous or induced labor, requesting labor epidural analgesia, were randomized to receive either a multiport (Group B, n=34) or uniport (Group A, n=25) B. Braun Perifix FX springwound catheter. All parturients were seated, and using a midline approach and loss of resistance to air to access the epidural space the allocated catheter was left 5 cm in the epidural space. Following negative aspiration and test dose for intravascular or intrathecal placement 15 ml of 0.1% bupivacaine plus fentanyl 2 mcg/ml were administered to initiate labor analgesia, followed by a continuous infusion of the same solution for maintenance of labor analgesia. A blinded investigator collected primary and secondary data to include complete analgesia (primary outcome), defined as complete relief of pain during contractions following the initiation of labor analgesia; paresthesias; intravascular cannulation; maternal satisfaction with labor analgesia; and catheter breakage. Data were analyzed using Chi square and Student’s t-tests with variance, and a p value < 0.01 was considered statistically significant.
Results: There was no difference in maternal age, weight, height or gestational age between the two groups. The incidence of complete analgesia was 85% in Group B and 100% in Group A (p=0.04). There were no paresthesias or intravascular cannulation in either group. Maternal satisfaction with labor analgesia was rated as good to excellent in 85% and 92% of parturients in Group B and Group A, respectively (p=0.37). There were no catheter breakages in either group.
Conclusions: There were no significant differences in complete analgesia; paresthesias; intravascular cannulation; maternal satisfaction with labor analgesia; or catheter breakage between the multiport versus uniport B. Braun Perifix FX springwound catheter.
1. Anesthesiology 2006; 105: A904.
2. Anesth Analg 1997; 84: 1276-9.
3. Anesth Analg 2006; 102: 1595.